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Crestal Approach and Lateral Window

Written by DTC Miami

 Created 06/4/2018

The first sinus lift in the world was done in 1974, less than 50 years ago, by Dr. Hilt Tatum. Sinus lift has two different techniques known as Lateral Window and Crestal Approach. The lateral window approach is a direct method, while the crestal approach is indirect. Understanding both of these techniques is crucial, especially, when considering which technique is most suitable for a patient. Lateral wall sinus elevation is carried out when the bone is severely deficient, even though, this technique is highly successful, surgical complications can arise (1). For this reason, it is critical to understand the theoretical aspects of these two sinus lift approaches and also be able to have guidance when performing one. Learning about implantology is equally as important about learning the crestal approach and lateral window technique for sinus lift. Some patients will come to your clinic with an atrophic maxilla. According to a study from the National Journal of Maxillofacial Surgery, “….[it] reveals that lateral antrostomy allowed for a greater amount of bone augmentation to the atrophic maxilla but required a larger surgical access. The crestal approach is minimally invasive but permits only a limited amount of augmentation which is similar to the observations of Woo et al.[22]” (2).  This study was comparing both sinus lift techniques to determine which was more effective on a series of factors such as pain and inflammation among others.


Evidently, the crest approach and lateral window is studied thoroughly because of its importance in restoring bone within the maxilla and providing patients with a healthy and proper smile. Last year in December, we had Dr. Samuel Lee be a guest speaker in our training facility to discuss a new sinus classification. Further, our instructors Dr. Juan Buitrago and Dr. Lester Gil have discussed sinus lift in our course Sinus Lifting and Advanced Bone Grafting. Our course offers one-on-one mentoring for a sinus lift surgical module for Florida licensed dentists. Understanding the theoretical concepts of sinus lift, lateral window and crestal approach are important for performing them properly in a practical and surgical module. We are the only center that offers the opportunity for mentoring when performing sinus lift and its two respective techniques.

Figure 19: In this postoperative periapical, the round, contained shape of the bone graft indicates that the repair was successful.

Photo: J Can Dent Assoc 2013;79:d101